Provider Demographics
NPI:1598389637
Name:MERCIE HEALTH
Entity Type:Organization
Organization Name:MERCIE HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/MEDICAL PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:SYLVIA
Authorized Official - Middle Name:UDOKORO
Authorized Official - Last Name:NWAKANMA
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:770-835-5305
Mailing Address - Street 1:3721 NEW MACLAND RD STE 246
Mailing Address - Street 2:
Mailing Address - City:POWDER SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30127-2000
Mailing Address - Country:US
Mailing Address - Phone:678-446-4298
Mailing Address - Fax:587-200-1005
Practice Address - Street 1:3721 NEW MACLAND RD STE 246
Practice Address - Street 2:
Practice Address - City:POWDER SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30127-2000
Practice Address - Country:US
Practice Address - Phone:770-835-5305
Practice Address - Fax:587-200-1005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-04
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care